This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Kralj, B. Articles by Ashbury, F. D. Search for Related Content PubMed PubMed Citation Articles by Kralj, B. Articles by Ashbury, F. D. Pubmed/NCBI databases Substance via MeSH Medline Plus Health Information Anemia Cancer Cancer Chemotherapy Social Bookmarking                         What's this?

The Impact of Computerized Clinical Reminders on Physician Prescribing Behavior: Evidence From Community Oncology Practice

Optx Corporation, Denver, CO, and Ontario Medical Association and University of Toronto, Toronto, Ontario, Canada

Donald Iverson, PhD

Optx Corporation, Denver, CO, and University of Wollongong, New South Wales, Australia

Ken Hotz, PhD

Optx Corporation, Denver, CO

Fredrick D. Ashbury, PhD

Optx Corporation, Denver, CO, and Department of Oncology, McGill University, Montreal, Quebec, Canada, and Department of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada, fredash{at}optxcorp.com

The objective of this study is to examine the impact of a clinical reminder generated by an electronic medical record (EMR) system on physician prescribing behavior in community oncology practice setting. A case-control trial assessing the prescribing rates of erythropoietin by physicians is used. The participants and setting involves a total of 11,644 physician-patient encounters in 2 community oncology practices in the United States during a 21-month period. The intervention is a clinical reminder generated in real time during a physician-patient encounter by an EMR identifying cancer patients with low hemoglobin (Hgb) levels (ie, anemic), that is, patients with Hgb less then 12 g/dL. The main outcome measure is to determine the frequency of erythropoietin prescription by physicians to cancer patients with low Hgb levels. Implementation of a clinical reminder generated by way of an EMR significantly improved the likelihood of low-Hgb patients receiving treatment with erythropoietin. Low-Hgb patients in the experimental clinic during the time that the clinical reminder system was in place were almost twice as likely (ie, adjusted odds ratio = 1.92, P = .008) to have been treated with erythropoietin. The data support the effectiveness of clinical reminders as a way to influence physician prescribing behaviors and potentially improve the quality of patient care. However, we feel that there is a need to investigate the use of reminders in other aspects of cancer care that may be undertreated or when new drugs may be available but are underused.

Key Words: Anemia • community oncology practice • electronic clinical reminders • physician behaviors

American Journal of Medical Quality, Vol. 18, No. 5, 197-203 (2003)
DOI: 10.1177/106286060301800504


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				D. M. Murray, S. L. Pals, J. L. Blitstein, C. M. Alfano, and J. Lehman Design and Analysis of Group-Randomized Trials in Cancer: A Review of Current Practices J Natl Cancer Inst, April 2, 2008; 100(7): 483 - 491. [Abstract] [Full Text] [PDF]

				J. C. Garrelts, A. Meister, and J. Bond Effect of preprinted order form on epoetin alfa prescribing Am. J. Health Syst. Pharm., August 15, 2007; 64(16): 1732 - 1738. [Abstract] [Full Text] [PDF]

				L. G. Pawlson Health Information Technology: Does It Facilitate Or Hinder Rapid Learning? Health Aff., March 1, 2007; 26(2): w178 - w180. [Abstract] [Full Text] [PDF]